13 research outputs found

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    Radiation exposure to the hand

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    Study Design: Prospective study. Purpose: During fluoroscopically guided spinal procedure, the hands of spinal surgeons are placed close to the field of radiation and may be exposed to ionizing radiation. This study directly measured the radiation exposure to the hand of a spinal interventionalist during fluoroscopically guided procedures. Overview of Literature: Fluoroscopically guided spinal procedures have been reported to be a cause for concern due to the radiation exposure to which their operators are exposed. Methods: This prospective study evaluated the radiation exposure of the hand of one spinal interventionalist during 52 consecutive fluoroscopic spinal procedures over a 3-month period. The interventionalist wore three real-time dosimeters secured to the right forearm, under the lead apron over the chest, and outside the lead apron over the chest. Additionally, one radiophotoluminescence glass dosimeter was placed under the lead apron over the left chest and one ring radiophotoluminescence glass dosimeter was worn on the right thumb. The duration of exposure and radiation dose were measured for each procedure. Results: The average radiation exposure dose per procedure was 14.9 µSv, 125.6 µSv, and 200.1 µSv, inside the lead apron over the chest, outside the lead apron over the chest, and on the right forearm, respectively. Over the 3-month period, the protected radiophotoluminescence glass dosimeter over the left chest recorded less than the minimum reportable dose, whereas the radiophotoluminescence glass ring dosimeter recorded 368 mSv for the thumb. Conclusions: Our findings indicated that the cumulative radiation dose measured at the dominant hand may exceed the annual dose limit specified by the International Commission on Radiological Protection. Spinal interventionalists should take special care to limit the duration of fluoroscopy and radiation exposure

    Radiation Exposure to the Hand of a Spinal Interventionalist during Fluoroscopically Guided Procedures

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    Study DesignProspective study.PurposeDuring fluoroscopically guided spinal procedure, the hands of spinal surgeons are placed close to the field of radiation and may be exposed to ionizing radiation. This study directly measured the radiation exposure to the hand of a spinal interventionalist during fluoroscopically guided procedures.Overview of LiteratureFluoroscopically guided spinal procedures have been reported to be a cause for concern due to the radiation exposure to which their operators are exposed.MethodsThis prospective study evaluated the radiation exposure of the hand of one spinal interventionalist during 52 consecutive fluoroscopic spinal procedures over a 3-month period. The interventionalist wore three real-time dosimeters secured to the right forearm, under the lead apron over the chest, and outside the lead apron over the chest. Additionally, one radiophotoluminescence glass dosimeter was placed under the lead apron over the left chest and one ring radiophotoluminescence glass dosimeter was worn on the right thumb. The duration of exposure and radiation dose were measured for each procedure.ResultsThe average radiation exposure dose per procedure was 14.9 µSv, 125.6 µSv, and 200.1 µSv, inside the lead apron over the chest, outside the lead apron over the chest, and on the right forearm, respectively. Over the 3-month period, the protected radiophotoluminescence glass dosimeter over the left chest recorded less than the minimum reportable dose, whereas the radiophotoluminescence glass ring dosimeter recorded 368 mSv for the thumb.ConclusionsOur findings indicated that the cumulative radiation dose measured at the dominant hand may exceed the annual dose limit specified by the International Commission on Radiological Protection. Spinal interventionalists should take special care to limit the duration of fluoroscopy and radiation exposure

    Microbleed clustering in thalamus sign in CADASIL patients with NOTCH3 R75P mutation

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    Background and objectiveCerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an inherited cerebral microvascular disease characterized by the development of vascular dementia and lacunar infarctions. This study aimed to identify the genetic and clinical features of CADASIL in Japan.MethodsWe conducted genetic analysis on a case series of patients clinically diagnosed with CADASIL. Clinical and imaging analyses were performed on 32 patients with pathogenic mutations in the NOTCH3 gene. To assess the presence of cerebral microbleeds (CMBs), we utilized several established rating scales including the Fazekas scale, Scheltens rating scale, and Microbleed Anatomical Rating Scale, based on brain MRI images.ResultsAmong the 32 CADASIL patients, 24 cases were found carrying the R75P mutation in NOTCH3, whereas the remaining eight cases had other NOTCH3 mutations (R75Q, R110C, C134F, C144F, R169C, and R607C). The haplotype analysis of the R75P mutation uncovered the presence of a founder effect. A brain MRI analysis revealed that cases with the R75P mutation had a significantly higher total number of CMBs, particularly in the thalamus when compared to patients with other NOTCH3 mutations. Among 15 out of 24 cases with the R75P mutation, we observed a notable clustering of CMBs in the thalamus, termed microbleed clustering in thalamus sign (MCT sign).ConclusionWe propose that the MCT sign observed in NOTCH3 R75P-related CADASIL patients may serve as a potentially characteristic imaging feature. This finding offers further insights into the interactions between genotypes and phenotypes between NOTCH3 and CADASIL
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